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Quizzes > Quizzes for Business > Healthcare

Nursing Fluid & Electrolyte Management Quiz Challenge

Sharpen Your Clinical Fluid and Mineral Balance Skills

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art promoting a quiz on Nursing Fluid and Electrolyte Management

Ready to conquer fluid balance and electrolyte management? This Nursing Fluid & Electrolyte Management Quiz is perfect for nursing students, educators, and clinicians seeking to sharpen their critical care skills. With 15 multiple-choice questions covering patient scenarios and lab interpretations, participants can identify gaps in knowledge and boost clinical confidence. Explore similar assessments like the Medical-Surgical Nursing Electrolyte and Acid-Base Quiz or the Nursing Fundamentals Knowledge Assessment , and customize your learning freely in our quizzes editor.

A patient presents with dry mucous membranes, tachycardia, and low urine output. Which fluid status best describes this presentation?
Hypovolemia
Hypervolemia
Euvolemia
Third-spacing
The signs of dry mucous membranes, tachycardia, and oliguria indicate intravascular volume depletion consistent with hypovolemia. These features occur when fluid loss exceeds intake.
Which clinical sign is most indicative of hypernatremia?
Confusion
Bradycardia
Polyuria
Hypotension
Hypernatremia increases serum osmolality, drawing water out of brain cells and causing neurological symptoms such as confusion. Cardiovascular signs are less specific.
What is the normal serum potassium range in mEq/L?
2.5 - 3.5
3.5 - 5.0
5.0 - 7.0
1.5 - 2.5
The normal serum potassium range is 3.5 to 5.0 mEq/L. Values outside this range indicate hypo- or hyperkalemia.
Which intravenous solution is considered isotonic with plasma?
0.9% Sodium Chloride
0.45% Sodium Chloride
5% Dextrose in Water
10% Dextrose in Water
A 0.9% sodium chloride solution has an osmolarity close to plasma and is considered isotonic. Hypotonic solutions like 0.45% saline and dextrose solutions differ in tonicity.
A blood pH of 7.48 indicates which acid-base imbalance?
Normal pH
Alkalosis
Acidosis
Cannot interpret
A pH above the normal range (7.35 - 7.45) indicates alkalosis. In this case, a pH of 7.48 is clearly alkalotic.
Third-spacing refers to fluid shifting into which compartment?
Interstitial (nonfunctional)
Intravascular
Intracellular
Transcellular
Third-spacing describes fluid accumulation in the interstitial or nonfunctional extracellular space, reducing intravascular volume. This shift can cause edema and hypotension.
A patient has serum sodium 120 mEq/L, glucose 90 mg/dL, and BUN 14 mg/dL. What is the approximate serum osmolality?
120 mOsm/kg
250 mOsm/kg
280 mOsm/kg
300 mOsm/kg
Calculated serum osmolality ≈ 2×Na + glucose/18 + BUN/2.8 = 240 + 5 + 5 = 250 mOsm/kg. This low value indicates hypoosmolar hyponatremia.
Using the 4-2-1 rule, what is the hourly maintenance fluid rate for a 70 kg adult?
70 mL/hr
100 mL/hr
110 mL/hr
130 mL/hr
The 4-2-1 rule gives 4 mL/kg for the first 10 kg (40 mL), 2 mL/kg for the next 10 kg (20 mL), and 1 mL/kg for remaining 50 kg (50 mL), totaling 110 mL/hr.
An ABG shows pH 7.22, HCO3 - 14 mEq/L, PaCO2 40 mmHg. What is the primary disturbance?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
A low pH with low HCO3 - and normal PaCO2 indicates a primary metabolic acidosis. The CO2 is not elevated enough to suggest respiratory acidosis.
Which clinical sign is commonly seen in hypomagnesemia?
Muscle cramps and tetany
Bradycardia
Polyuria
Hypertension
Low magnesium increases neuromuscular excitability, leading to muscle cramps and tetany. Cardiac effects can occur but cramps and twitching are most common.
Peaked T waves on an ECG are most characteristic of which electrolyte imbalance?
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypomagnesemia
Elevated serum potassium shortens repolarization time and produces peaked T waves. Hypokalemia typically flattens T waves instead.
Calculate the anion gap given Na 140, Cl 100, HCO3 - 16 (all in mEq/L).
14
24
34
44
Anion gap = Na - (Cl + HCO3) = 140 - (100 + 16) = 24. A normal gap is 8 - 16 mEq/L, so 24 indicates an elevated gap.
In severe symptomatic hyponatremia due to SIADH, which IV fluid is most appropriate initially?
0.45% Sodium Chloride
0.9% Sodium Chloride
3% Sodium Chloride
5% Dextrose in Water
Hypertonic (3%) saline is used to raise serum sodium acutely in severe symptomatic hyponatremia. Hypotonic or isotonic solutions are insufficient.
An ABG shows pH 7.36, PaCO2 55 mmHg, HCO3 - 30 mEq/L. What does this indicate?
Acute respiratory acidosis
Chronic (compensated) respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Elevated PaCO2 with normal pH and elevated HCO3 - indicates a chronic respiratory acidosis with renal compensation. Acute cases do not have elevated HCO3 - .
An ABG shows pH 7.50, PaCO2 48 mmHg, HCO3 - 35 mEq/L. What is the primary disturbance?
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis
A high pH with elevated HCO3 - and moderately elevated PaCO2 indicates primary metabolic alkalosis with respiratory compensation. The CO2 rise is compensatory.
A 30 kg child is estimated to be 6% dehydrated. What is the fluid deficit?
180 mL
600 mL
1.8 L
3.0 L
Fluid deficit = body weight × percent dehydration = 30 kg × 0.06 = 1.8 L. This guides initial replacement planning.
An ABG shows pH 7.40, PaCO2 30 mmHg, HCO3 - 18 mEq/L. Which acid-base disorder is present?
Respiratory acidosis
Metabolic acidosis
Mixed metabolic acidosis and respiratory alkalosis
Normal acid-base balance
Normal pH with low PaCO2 and low HCO3 - indicates two opposing primary disturbances: respiratory alkalosis and metabolic acidosis occurring together.
A patient has serum K+ 2.8 mEq/L and you need to raise it to 4.0 mEq/L. Approximately how many mEq of KCl are required?
40 mEq
80 mEq
120 mEq
160 mEq
Each 10 mEq of KCl raises serum K+ by about 0.1 mEq/L in a 70 kg adult. To increase from 2.8 to 4.0 (1.2 mEq/L) requires ~120 mEq.
Which laboratory and clinical findings are characteristic of Bartter syndrome?
Metabolic acidosis, hyperkalemia, hypotension
Metabolic alkalosis, hypokalemia, normal blood pressure
Respiratory alkalosis, hypernatremia, hypertension
Metabolic alkalosis, hyperkalemia, hypertension
Bartter syndrome mimics chronic loop diuretic use, leading to hypokalemic metabolic alkalosis with normal to low blood pressure. Renin and aldosterone are elevated.
In severe symptomatic hyponatremia, what is the recommended initial hypertonic saline bolus?
100 mL of 3% saline over 10 minutes
200 mL of 3% saline over 4 hours
500 mL of 3% saline over 2 hours
1000 mL of 3% saline over 6 hours
Current guidelines recommend a 100 mL bolus of 3% saline over 10 minutes, which can be repeated up to two times for severe neurologic symptoms. This raises serum sodium promptly.
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Learning Outcomes

  1. Analyse patient scenarios to detect fluid imbalances
  2. Evaluate electrolyte disturbances using lab values
  3. Apply IV therapy principles to address fluid deficits
  4. Demonstrate understanding of acid-base balance mechanisms
  5. Identify clinical signs of common electrolyte imbalances

Cheat Sheet

  1. Understand Body Fluid Compartments - Think of your cells as VIP rooms (intracellular) and the surrounding hallways (extracellular), which include blood plasma and interstitial spaces. Knowing these "rooms" helps you map fluid shifts in dehydration or edema and plan treatments like a pro. NCBI Fluid Compartments
  2. Spot Fluid Volume Deficit - Dehydration isn't just about being thirsty; watch for dry mucous membranes, low urine output, and dropping blood pressure. Catching these signs early means you can jump into rehydration mode before things get serious! NCBI Dehydration Guide
  3. Detect Fluid Volume Excess - When your body's fluid tanks overflow, you might see swelling (edema), high blood pressure, and lung congestion. Keeping an eye on these clues helps you manage conditions like heart failure and keep your patients breathing easy. NCBI Fluid Overload Tips
  4. Memorize Key Electrolyte Ranges - Sodium (135 - 145 mEq/L), potassium (3.5 - 5.0 mEq/L), calcium (8.5 - 10.5 mg/dL), magnesium (1.5 - 2.5 mEq/L): these numbers are your best friends when you interpret lab results. Lock them in your brain to decode patient data like a champ. NCBI Electrolyte Norms
  5. Know Electrolyte Imbalance Causes & Symptoms - From hyponatremia (low sodium) to hypermagnesemia (high magnesium), each imbalance has its own telltale flags - think muscle cramps, twitching, or confusion. Spotting these patterns fast means faster fixes and happier patients. NCBI Electrolyte Imbalances
  6. Pick the Right IV Fluids - Isotonic (0.9% NaCl), hypotonic (0.45% NaCl), or hypertonic (3% NaCl): choosing the correct bag is like picking the right key for a lock to restore balance. Master this and you'll be the IV hero! NCBI IV Fluid Types
  7. Dive into Acid-Base Balance - Your lungs and kidneys team up to keep blood pH between 7.35 and 7.45, battling acidosis or alkalosis like superheroes. Understanding their tactics helps you troubleshoot pH chaos with confidence. OpenStax Acid-Base Balance
  8. Interpret Arterial Blood Gases (ABGs) - Reading pH, PaCO₂, and HCO₃❻ values is like solving a puzzle to uncover acid-base status. Once you nail ABG interpretation, diagnosing respiratory or metabolic disturbances becomes second nature. OpenStax ABG Interpretation
  9. Recognize Clinical Signs of Electrolyte Woes - Ever heard of Trousseau's sign (carpal spasm) in low calcium or Chvostek's sign (facial twitch) in magnesium issues? These physical exam tricks are diagnostic gold - practice them like magic spells! NCBI Clinical Signs
  10. Monitor Urine Specific Gravity - A reading between 1.005 and 1.030 tells you if someone's hydration and kidney function are on point. Tracking this simple number helps you catch fluid imbalances before they escalate. NCBI Urine Specific Gravity
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